肺肠同治理论辨治慢性阻塞性肺疾病临床研究  

Treatment of Chronic Obstructive Pulmonary Disease from Perspective of "Lung and Large Intestine Being Regulated Simultaneously" TCM Theory

作　　者：王永杰 魏丹丹[2] 孔蕊 李玉洁[2] 

机构地区：[1]河南省职业病研究院,河南郑州450000 [2]河南中医药大学,河南郑州450046 [3]许昌市中心医院,河南许昌461000

出　　处：《中医学报》2017年第5期733-736,共4页Acta Chinese Medicine

摘　　要：目的:观察肺肠同治理论用于治疗慢性阻塞性肺疾病的临床疗效。方法:将180例慢性阻塞性肺疾病患者随机分成观察组90例和对照组90例。对照组采用常规西药治疗。观察组在对照组治疗基础上加用中医学肺肠同治理论辨证论治:痰热阻肺证采用宣白承气汤加减治疗,方药组成:厚朴10 g,生石膏20 g,茯苓10 g,陈皮10 g,甘草6 g,莱菔子10g,瓜蒌皮20 g,大黄9 g,清半夏10 g,炙麻黄10 g,苦杏仁15 g,水煎服,每日1剂,分两次服用;肺肾阴虚证采用增液承气汤加减治疗,方药组成:大黄9 g,生地黄20 g,熟地黄10 g,玉竹10 g,天花粉10 g,芒硝10 g,玄参20 g,麦冬15 g,生甘草6 g,百合10 g,水煎服,每日1剂,分两次服用。治疗后比较两组患者Pa O2、Pa CO2、p H值、用力肺活量(forced vital capacity,FVC)、第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、FEV1/FVC比值及两组患者的临床疗效。结果:治疗后观察组Pa O2(70.2±8.5)mm Hg(1 mm Hg=0.133 k Pa)、Pa CO2(44.3±3.9)mm Hg、p H值(7.36±0.20),两组比较,差异均有统计学意义(P<0.05);观察组FVC(2.8±0.5)L、FEV1(1.8±0.4)L、FEV1/FVC(64.3±9.0)%,两组比较,差异均有统计学意义(P<0.05);观察组有效率为94.4%,对照组有效率为76.7%,两组比较,差异有统计学意义(P<0.05)。结论:采用肺肠同治理论辨证论治慢性阻塞性肺疾病疗效确切,可改善患者的临床症状及预后,不良反应少。Objective：To observe the clinical efficacy of treatment of Chronic obstructive pulmonary disease from perspective of ＂ Lung and Large Intestine being regulated simultaneously＂ TCM Theory as they are a Coupled Zang-fu Unit. Methods ：180 patients with Chronic obstructive pulmonary disease were randomly divided into observation group （ n = 90） and control group （ n = 90 ）. The control group was treated with conventional western medicine. The observation group was treated according to ＂ Lung and Large Intestine Being a Coupled Zang-fu Unit＂ theory in traditional Chinese medicine in addition to that of the control group：patients with Phlegm-heat Obstructing Lung Syndrome was treated by using modified Xuanbai Chengqi Decoction, the prescription of which was ： Magnolia 10g. Gvosum 20 g,Poria 10 g, Dried tangerine oeel 10 g, Licorice 6g,Tadish seed 10 g, Melon skin 20 g, Rhubarb 9 g, Chrysanthemum 10 g, Sunburn ephedra 10 g, Bitter almond 15 g. The decoction was taken twice a day. Patients with Lung and Kidney Yin Deficiency Syndrome of were given modified Zengye Chengqi Decoction in treatment. The prescription was ： rhubarb 9 g,Rehmannia 20 g,Rehmannia glutinosa 10 g,Polygonatum 10 g,Trichosanthin 10 g,Glauber＇s salt 10 g,Scrophulariaceae 20 g, Ophiopogon japonicus 15 g, raw licorice 6 g, lily 10 g. The decoction was taken twice a day. After treatment, levels of PaO2, PaCO2, pH, forced vital capacity （ FVC ）, forced expiratory volume in one second （ FEV1 ）, FEV1 / FVC ratio and Clinical efficacy of the two groups were compared. Results ： After treatment, the levels of PaO2 （70.2 ± 8.5 ） mmHg, PaCO2 （44.3 ＋ 3.9） mmHg and pH value （7.36± 0.20） were significantly different from those of the control groups （ P 〈 0.05 ）. The FEV1 / FVC （ 64.3± 9.0） % of the observation group were significantly different from those of the control group （ P 〈 0.05 ）. The effective rate of the observation group was 94.4% and that of the the control group was 76.7% , the diff

关 键 词：“肺肠同治” 慢性阻塞性肺疾病 痰热阻肺证 肺肾阴虚证 用力肺活量 第1秒用力呼气容积 中西医结合 

分 类 号：R259.63[医药卫生—中西医结合]